June 19, 2017 E-Pearl of the Week: Tolosa-Hunt syndrome

Interested in submitting an E-Pearl?
Brought to you by the Residents & Fellows Section of Neurology®.

June 19, 2017

Tolosa-Hunt syndrome

Tolosa- Hunt syndrome is an ophthalmoplegia caused by an inflammatory process of unknown etiology in the region of the cavernous sinus, orbital apex, or superior orbital fissure. Clinical presentation includes headache and episodic orbital pain associated with paralysis of one or more of the III, IV, and/or VI cranial nerves which usually resolves spontaneously, but tends to relapse and remit. The diagnosis is usually one of exclusion. Corticosteroids are the treatment of choice, usually providing significant pain relief within 24-72 hours of therapy initiation.


  1. The International Classification of Headache Disorders, 3rd edition (beta version). Headache Classification Committee of the International Headache Society (IHS). Cephalalgia 2013; 33: 629-808. doi: 10.1177/0333102413485658.

Submitted by Gurcharanjeet Kaur, MBBS, FAAP - Child Neurology Resident, Stony Brook University Hospital. 

Dr. Kaur reports no disclosures.

For more clinical pearls and other articles of interest to neurology trainees, visit Neurology®.

Visit the E-Pearl of the Week archive.  

Listen to this week's Neurology Podcast


Forgot password?